I would first sweep through each baby to see get my bearings, then I will move to moms anatomy including, cervix, ovaries, uterus, and placenta. Then I would continue to treat a multiple gestation pregnancy just as a single pregnancy. Taking one at a time, starting with baby A (the one closest to the cervix) and then moving to baby b and c and so on, making sure to labeled each fetus correctly as I move along. I think this would help me stay consistent and on track with what I'm scanning. Jumping around from baby to baby would be extremely confusing and I would most likely forget things. The radiologist also has to be able to understand the scan so being consistent is really important for their sake as well. I would stick to my same protocol for a singleton, and just double or triple it. 

Twin to Twin Transfusion Syndrome, where twins share one placenta  and one of the twins ends up being a donor for the other because the vessels are not evenly dispensed between the 2 fetuses. The donor ends up giving away more blood than it receives and is at risk for malnourishment and the recipient is at risk for receiving too much blood and can overwork the heart. 

Twin Embolization Syndrome is a complication of monozygotic twinning following in utero demise of the co-twin. Passage of thromboplastic material into the circulation of the surviving twin results in ischemic structural defects in various organs 

Twin Reversed-Arterial Perfusion arises when the cardiac system of one twin (pump twin) does the work of supplying blood for both twins. The increased pumping of the heart puts this twin at risk for cardiac failure. The receiving twin (acardiac twin) lacks a heart or has one that is not fully formed. 

Documenting these pathologies is extremely important and can cause so many other issues down the line so being precise and accurate is so so important. It's also important to be consistent like I mentioned before because if someone comes behind you to scan this patient again, and they can't be sure which baby is which from your scan, it's will go downhill and the tech doing the follow up will have an extremely hard time. The pathologies I mentioned are vascular anomalies so throwing on color will be very important to prove the  diagnoses, rather than with something like conjoined twins I would want to clearly see the attachment site and also include color to see if any vascularity is attaching them as well like we saw in the power point today.